Today CPR submitted a brief to the Supreme Judicial Court of Massachusetts on behalf of C.R., a person with a psychiatric disability who was confined for almost a week in a hospital emergency department. The brief was filed by CPR, the Mental Health Legal Advisors Committee, and the Disability Law Center.
In Massachusetts, as in most states, persons with mental illness can be restrained and involuntarily kept in a facility if they present a risk of harm to themselves or someone else. State statutes allow for short-term detention – from several days to a few weeks – by a health care professional or a police office, until a court can hold a hearing and decide if the person presents a serious risk of harm to herself or others. In Massachusetts, this emergency detention is limited to three days.
This case raises the issue of when the three days begins. Many persons with psychiatric disabilities are first restrained and taken to emergency departments, often without any consideration of whether community treatment is available, and then involuntarily detained in these hospitals for days or weeks without mental health care. The hospital claims that detention in the emergency department does not count in the three day limit. C.R challenged his commitment after the Massachusetts General Hospital (MGH) kept him in its emergency department for five days before asking a court to commit him.
CPR’s brief, submitted in support of C.R., argues that emergency departments do not provide needed mental health care and often exacerbate a person’s symptoms and condition. Professionals, researchers, and hospital licensing bodies agree that community-based care, like mobile crisis intervention, crisis stabilization, and intensive community services, is far preferable, less-expensive, and more effective than confinement in emergency departments. The brief argues that both the legal right to the least restrictive alternative and the clinical benefits of community care require health care professional to consider these alternatives before restraining someone with a mental illness in an emergency department.
You can read the full brief here.